Ward P C, Smith C M, White J G
Am J Clin Pathol. 1979 Sep;72(3):479-85. doi: 10.1093/ajcp/72.3.479.
Examination of peripheral blood smears from a patient with sickle cell disease during crisis associated with an upper respiratory tract infection, pneumonia, a positive Coombs test, and an elevated cold agglutinin titer revealed unique abnormalities associated with her erythrocytes, which have not been reported previously. In addition to the usual changes in peripheral blood occurring during crisis in sickle cell anemia, large numbers of free, filamentous forms that appeared to be derived from erythrocytes were present on repeated Wright's-stained smears. Erythrocytes were markedly distorted and had single and multiple surface protrusions that appeared to be antecedents of the free filamentous forms. Scanning electron microscopy confirmed the marked changes in the erythrocytes and revealed membrane alterations not apparent by use of the light microscope. It is suggested that the membrane stripping observed in this case was due to cold agglutinin--complement-mediated surface injury superimposed on the known abnormalities of the membranes of sickle erythrocytes.
对一名镰状细胞病患者在与上呼吸道感染、肺炎、抗人球蛋白试验阳性及冷凝集素效价升高相关的危象期间的外周血涂片进行检查，发现其红细胞存在独特的异常，此前未见报道。除了镰状细胞贫血危象期间外周血通常出现的变化外，在反复进行的瑞氏染色涂片上还存在大量似乎源自红细胞的游离丝状形式。红细胞明显变形，有单个和多个表面突起，这些突起似乎是游离丝状形式的前身。扫描电子显微镜证实了红细胞的显著变化，并揭示了光学显微镜下不明显的膜改变。提示本例中观察到的膜剥离是由于冷凝集素 - 补体介导的表面损伤叠加在镰状红细胞膜已知异常之上。
